Physician Compare National (NPI:1558774414)

HEALTHCARE PROVIDER: RAYMOND LEE HUNSUCKER III D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1558774414
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8820343080
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180612003227
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HUNSUCKER
	Individual professional last name
Provider First Name	RAYMOND
	Individual professional first name
Provider Middle Name	LEE
	Individual professional middle name
Provider Name Suffix Text	III
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
	Individual professional's medical school
Graduation Year	2014
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	LAKEFRONT EMERGENCY PHYSICIANS MEDICAL GROUP, S.C.
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	2264865476
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	11
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	4646 N MARINE DR
	Group Practice or individual's line 1 address
City	CHICAGO
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	606405759
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7738788700
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140133
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HOLY CROSS HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	140082
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	LOUIS A WEISS MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	140018
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MT SINAI HOSPITAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	M